Device and method of reducing bias flow in oscillatory ventilators
Summary by NHIP
Reducing bias flow in ventilators
The device attaches to an oscillating ventilator to reduce bias flow using a specific gas circuit configuration. A check valve sits in the oscillating line between the two ends of the return line, while a CO2 scrubber containing sodium hydroxide, calcium hydroxide, or barium hydroxide resides in either the oscillating or return line.
Claim Score by NHIP
Abstract
A device and method of ventilating a patient reduces the bias flow relative to existing oscillatory ventilators. The device has a gas flow circuit including an oscillating line, a patient line and an exhalation or a return line. A gas supply line and an outlet valve are in pneumatic communication with the gas flow circuit. One or more CO2 scrubbers and one or more check valves are provided in the circuit. A method of ventilating using such a device is also disclosed.

Term
Term ended
Expired 5 June 2021, 5.3 years ago.
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28 claims: 4 independent, 24 dependent
- 1Broadest claimClaim Score 66, broad(NHIP)A device for attachment to an oscillating ventilator having an oscillatable diaphragm, comprising a gas flow circuit comprising:an oscillating line having a first end and a second end, wherein the first end is adapted for communication with the oscillatable diaphragm;a patient line connected to the second end of the oscillating line;a return line, wherein both ends of the return line are connected to the oscillating line;a check valve in the oscillating line located between the two ends of the return line;and a CO2 scrubber located in the oscillating line or return line.
- 10A device for attachment to an oscillating ventilator having an oscillatable diaphragm, comprising:a) a gas flow circuit comprising: an oscillating line having a first end and a second end, wherein the first end is adapted for pneumatic communication with the oscillatable diaphragm;a patient line connected to the second end of the oscillating line;a return line, wherein both ends of the return line are connected to the oscillating line;a check valve in the oscillating line located between the two ends of the return line;a CO2 scrubber located in the oscillating line or return line, b) a gas supply line in pneumatic communication with the gas flow circuit;and c) an outlet valve in pneumatic communication with the gas flow circuit.
- 21A device for attaching to an oscillating ventilator having an oscillatable diaphragm, comprising:a) a gas flow circuit comprising: an oscillating line having a first end and a second end, the first end is adapted for connecting to the oscillatable diaphragm and having a check valve;a patient line connected to the second end of the oscillating line;and an exhalation line having one end connected to the patient line and the other end connected to the oscillating line and having a CO2 scrubber;b) a gas supply line in pneumatic communication with the gas flow circuit;and c) an outlet valve in pneumatic communication with the gas flow circuit.
- 27A method of ventilating, comprising the steps of:providing a ventilating device having an oscillatable diaphragm, a gas flow circuit comprising an oscillating line including a first end and a second end, wherein the first end is in pneumatic relationship with the oscillatable diaphragm and the second end is connected to a patient line, an exhalation line having a CO2 scrubber and connected to the patient line at one end and to the oscillating line at the other end, and further having a gas supply line and an outlet valve connected to the gas flow circuit, and a CO2 scrubber, and a check valve located in the oscillating line between the oscillatable diaphragm and the second end of the oscillating line;providing a patient connected to the patient line;supplying gas with the gas supply line to the gas flow circuit;and causing movement of the oscillatable diaphragm toward and away from the oscillating line.
Independent claims4
67 paragraphs in 5 sections, as filed
This application claims priority to U.S. provisional patent application No. 60/353,461 filed on Feb. 1, 2002 and is also a continuation in part of U.S. patent application Ser. No. 09/631,464 filed on Aug. 3, 2000, now U.S. Pat. No. 6,591,836, which in turn claims priority to U.S. provisional application No. 60/146,863, filed on Aug. 3, 1999, the disclosures of which are incorporated herein by reference.
FILED OF THE INVENTION
The present invention relates generally to ventilators for supporting breathing in animals. More particularly, the present invention provides a device and method of ventilating.
DISCUSSION OF RELATED ARTS
There are many situations in which normal breathing by an animal patient is impaired and must be assisted by external means. Oscillatory ventilators are used to facilitate breathing in such situations. Among the types of ventilators available are high frequency oscillating ventilators. U.S. Pat. No. 4,719,910 describes a high frequency oscillating ventilator. A flow of gas is conducted from a gas source to a high frequency oscillator. The high frequency oscillator comprises a housing including a magnet and having a diaphragmatically sealed piston mounted therein, an inlet connecting the space within the housing on the first side of the diaphragm to the gas conducting means, and a coil mounted to the first side of the diaphragm. Circuitry is provided which is operable to reverse the polarity of the flow of the current in the coil, thereby causing the diaphragm to move back and forth within the housing. A tube connecting the space on the second side of the diaphragm to the gas source and the patient's airway is provided.
In the prior art, inspiratory gas is moved into and out of the patient via a U-shaped tube and movement of the diaphragm. For purposes of describing the prior art, the U-shaped tube can be described as having a first limb with a distal end, a second limb with a distal end, and a tube between the limbs. Connected to the tube between the limbs is another tube (the “patient line”) that delivers gas from the U-shaped tube to the patient and also delivers gas from the patient to the U-shaped tube. The patient line may be connected to the patient via an endotracheal tube. The distal end of the first limb is placed in sealing relation to the diaphragm so that gas inside the U-shaped tube is caused to oscillate as the diaphragm moves back and forth. Gas suitable for inspiration (“inspiratory gas”) is supplied at a location on the U-shaped tube between the diaphragm and the patient line.
Inspiratory gas passes through the first limb of the U-shaped tube, and exhaled gas exits to the atmosphere through the second limb of the U-shaped tube and out of the distal end of the second limb. To prevent expired gases from being drawn back into the first limb during the expiratory phase of breathing, more inspiratory gas than needed by the patient is provided in order to move the expired gas into the second limb. The inspiratory gas provided in excess of the needs of the patient is referred to herein as “bias flow”.
To move expired gas into the second limb of the U-shaped tube, an inspiratory gas flow rate of approximately 20 liters per minute is used when ventilating infants, and as much as 60 to 80 liters per minute when ventilating older children and adults. Such large volumes of inspiratory gas would quickly exhaust the available supply of most transport and ambulance vehicles. Furthermore, such prior art devices necessitate large and costly volumes of therapeutic gases that might be mingled with the inspiratory gas (e.g., volatile anesthetics, nitric oxide, vaporized perfluorocarbons, helium/oxygen mixtures etc.). Finally, such prior art devices are inefficient when one considers the amount of inspiratory gas required by the patient and the relatively large amount of inspiratory gas supplied to the ventilator.
SUMMARY OF THE INVENTION
An object of the present invention is to provide a device and a method of ventilating. The object is achieved by a ventilating device having an oscillator, such as an oscillatory diaphragm, and gas flow circuit comprising an oscillating line having a first end in sealing or pneumatic relationship with the oscillator. A gas supply line is connected to the oscillating line, and a patient line is connected to a second end of the oscillating line. An outlet line is in pneumatic communication with the patient line, and an end of the outlet line distal from the patient line is connected to an outlet valve. The outlet valve releases gas from the outlet line during inhalation, and prevents the release of gas from the outlet line during exhalation. In one embodiment of the invention, the device has an oscillating line with a gas supply line connected thereto, a patient line connected to the second end of the oscillating line, an outlet line in pneumatic communication with the patient line, an outlet valve connected to the outlet line, one or more CO<sub>2 </sub>scrubbers and one or more check valves to ensure unidirectional flow of gas through the one or more scrubbers. This device of this embodiment can be attached to an oscillating ventilator.
In another embodiment, the device of the present invention is adapted for connecting to the U-type ventilator attachments of the prior art. In one embodiment of the invention, the device has a gas flow circuit comprising an oscillating line having a first end and a second end. The first end is adapted for connecting to an oscillating ventilator either directly or through another device such as a conventional U-type tube, a patient line connected to the second end of the oscillating line, a return line connected to the oscillating line, one or more CO<sub>2 </sub>scrubbers and one or more check valves to ensure unidirectional flow of gas. Optionally, the device may have an outlet valve and a gas supply line or when used in conjunction with a conventional U-type tube, may use the outlet valve and the gas supply line of the conventional U-type tube.
In a method according to the present invention, a ventilation device, such as the one described above, is provided. A patient in pneumatic communication with the patient line is provided and gas is supplied to the oscillating line. The oscillator is moved toward the oscillating line and the outlet valve is opened. Then, the oscillator is moved away from the oscillating line and the outlet valve is closed.
BRIEF DESCRIPTION OF THE DRAWINGS
For a fuller understanding of the nature and objects of the invention, reference should be made to the following description taken in conjunction with the accompanying drawings, in which:
<figref idref="DRAWINGS">FIG. 1</figref> is a schematic sectional view of a device according to the present invention illustrating the major components of the device and utilizing a CO<sub>2 </sub>scrubber.
<figref idref="DRAWINGS">FIGS. 2</figref><i>a </i>and <b>2</b><i>b </i>are schematic sectional representations of the closed and open positions respectively of an outlet valve according to the present invention.
<figref idref="DRAWINGS">FIGS. 3</figref><i>a </i>and <b>3</b><i>c </i>are each a schematic sectional representation of an embodiment of the present invention.
<figref idref="DRAWINGS">FIG. 3</figref><i>b </i>is a schematic sectional representation of another embodiment of the present invention.
<figref idref="DRAWINGS">FIGS. 4</figref><i>a </i>and <b>4</b><i>b </i>are schematic sectional views of other embodiments of the present invention having a CO<sub>2 </sub>scrubber.
<figref idref="DRAWINGS">FIG. 5</figref> is a schematic sectional representation of another embodiment of the present invention.
<figref idref="DRAWINGS">FIG. 6</figref> is a schematic sectional view of another embodiment of the invention without a CO<sub>2 </sub>scrubber.
<figref idref="DRAWINGS">FIGS. 7</figref><i>a </i>and <b>7</b><i>b </i>are schematic sectional representations of the closed and open positions respectively of another outlet valve according to the present invention.
<figref idref="DRAWINGS">FIG. 8</figref> is a flow chart showing steps of a method according to the present invention.
<figref idref="DRAWINGS">FIGS. 9</figref><i>a</i>, <b>9</b><i>b</i>, <b>9</b><i>c </i>and <b>9</b><i>d </i>are schematic sectional views of an embodiment of the invention that can be connected to a U-type oscillator tube (<b>9</b><i>a</i>, <b>9</b><i>b </i>and <b>9</b><i>c</i>) or to an oscillating ventilator (<b>9</b><i>d</i>).
DETAILED DESCRIPTION OF THE INVENTION
As used herein the term “gas” means a pure gas or a mixture of gases. Thus, the term “gas” may refer to a mixture of O<sub>2 </sub>and N<sub>2</sub>, and may include therapeutic gases.
A device <b>10</b> according to the present invention can be connected to an oscillating machine having an oscillator <b>11</b>, such as a diaphragm, like those described in U.S. Pat. No. 4,719,910 and U.S. Pat. No. 5,307,794. As illustrated in <figref idref="DRAWINGS">FIG. 1</figref>, an inspiratory gas source <b>5</b> is connected to a device <b>10</b> according to the present invention through supply line <b>8</b>. The flow of inspiratory gas into the device <b>10</b> can be regulated by a flow regulator <b>9</b> connected to supply line <b>8</b>. Preferably, the flow of inspiratory gas from supply line <b>8</b> and into connecting line <b>18</b> is essentially at a constant rate. Connecting line <b>18</b> is connected to the oscillating line <b>14</b>.
In the embodiment shown in <figref idref="DRAWINGS">FIG. 1</figref>, an inbound check valve <b>20</b> is in the oscillating line <b>14</b>. The portion of the oscillating line <b>14</b> that is downstream of the inbound check valve <b>20</b> is referred to herein as the inbound line <b>15</b>. The check valve <b>20</b> permits the flow of gas in the direction of arrow <b>21</b> and prevents the flow of gas in the opposite direction. When the pressure on the upstream side of the inbound check valve <b>20</b> is higher than the pressure on the downstream side of the inbound check valve <b>20</b>, the inbound check valve <b>20</b> opens allowing gas to flow in the direction of arrow <b>21</b>. When the pressure on the upstream side of the inbound check valve <b>20</b> is lower than on the downstream side, the inbound check valve <b>20</b> shuts, effectively stopping the flow of gas through inbound line <b>15</b>.
Further downstream of inbound check valve <b>20</b>, for example along inbound line <b>15</b> may be placed an O<sub>2 </sub>sensor <b>24</b> and a CO<sub>2 </sub>sensor <b>22</b> to monitor the quality of the gas therein. Additional modifiers and monitors like humidifiers, nebulizers and the like can also be installed. Inbound line <b>15</b> connects to patient line <b>25</b>, which is in turn connected to an endotracheal tube (not shown in <figref idref="DRAWINGS">FIG. 1</figref>) for delivery of gas to the patient's airways, and ultimately to the patient's lungs.
Inbound line <b>15</b> is also connected to exhalation line <b>30</b>. In exhalation line <b>30</b> may be placed a pressure monitoring device, such as a manometer, through port <b>28</b>. Exhalation line <b>30</b> includes a scrubber line <b>36</b> and connects to recirculation line <b>34</b>. Recirculation line <b>34</b> connects to the oscillating line <b>14</b>. At the junction of recirculation line <b>34</b> and scrubber line <b>36</b> is a two-position valve <b>32</b> which directs the flow of gas either toward the recirculation line <b>34</b> or toward the scrubber line <b>36</b>. The two position valve <b>32</b> is normally positioned to direct the flow of gas to the scrubber line <b>36</b>. Preferably, the two-position valve <b>32</b> is normally adjusted so that no gas flows through recirculation line <b>34</b>.
Included in the exhalation line <b>30</b> is a scrubber canister <b>38</b>, an outbound line <b>40</b>, and a discharge line <b>16</b>. A second scrubber <b>68</b> may also be included and used when the scrubber canister <b>38</b> is not being used, for example, while scrubber canister <b>38</b> is being replaced or recharged, for example, by purging CO<sub>2 </sub>using a separate flow of gas (not shown). The scrubber valves <b>70</b>A and <b>70</b>B preferably operate together so that either scrubber canister <b>38</b> or the second scrubber <b>68</b> is in operation. In a preferred embodiment, the scrubber valves <b>70</b>A and <b>70</b>B are not two separate valves, but instead a slide type valve, commonly used in the medical community, having an outer cylindrical shell and a movable inner cylinder, each with holes therethrough that allow either the scrubber canister <b>38</b> or the second scrubber <b>68</b> to be in service.
The outbound line <b>40</b> is fitted with an outbound check valve <b>42</b>, which permits the flow of gas in the direction of arrow <b>43</b> and prevents the flow of gas in the opposite direction. Downstream of the outbound check valve <b>42</b> is discharge line <b>16</b> having within it a shut-off valve <b>44</b>. The shut-off valve <b>44</b> is normally set to the open position. The shut-off valve <b>44</b> in its open position, permits the flow of gas, but in its closed position blocks the flow of gas. Discharge line <b>16</b> connects to oscillating line <b>14</b>.
Oscillating line <b>14</b> connects at one end to the patient line <b>25</b>, and is placed in sealing relationship at the other end with the oscillator <b>11</b>. Preferably, the oscillator <b>11</b> is a diaphragm of a high frequency oscillating machine. Connected to the oscillating line <b>14</b> is an outlet line <b>50</b>, which is in turn connected to outlet valve <b>52</b>. The outlet valve <b>52</b> may open and shut in response to a control pressure provided via control line <b>54</b>. The closed and open positions of outlet valve <b>52</b> are shown in <figref idref="DRAWINGS">FIGS. 2</figref><i>a </i>and <b>2</b><i>b </i>respectively. The external control pressure may be provided to control line <b>54</b> by the oscillating machine that controls the oscillator <b>11</b>. In one embodiment of the present invention, the control pressure provided by line <b>54</b> is substantially stable and the oscillating pressure in line <b>14</b> caused by movement of the diaphragm <b>11</b> causes the outlet valve <b>52</b> to open and close. Alternatively, operation of the outlet valve <b>52</b> may be by other means, such as a solenoid.
High frequency oscillation of the oscillator <b>11</b> facilitates movement of gas into and out of the patient's airways. Thus, during the inspiration phase, when the oscillator <b>11</b> is moving toward the oscillating line <b>14</b>, a pressurizing cycle occurs, and during the expiration phase, when the oscillator <b>11</b> is moving away from the oscillating line <b>14</b>, a depressurizing cycle occurs. During the pressurizing cycle, the pressure on the upstream side of the inbound check valve <b>20</b> increases, forcing it to open thereby allowing gas to flow in the direction of arrow <b>21</b>, and consequently into the patient's lungs via patient line <b>25</b>. At the same time, due to the oscillator <b>11</b> moving toward the device <b>10</b>, the pressure on the downstream side of outbound check valve <b>42</b> becomes higher than the pressure on its upstream side, which forces the outbound check valve <b>42</b> to close, thereby preventing the flow of gas from discharge line <b>16</b> into the scrubber canister <b>38</b>.
During the expiration phase (or depressurizing part of the cycle), the oscillator <b>11</b> moves away from the oscillating line <b>14</b> and the pressure differential across the inbound check valve <b>20</b> causes the inbound check valve <b>20</b> to close. The exhaled gas is pushed by the patient's lungs into exhalation line <b>30</b>, and into the CO<sub>2 </sub>scrubber canister <b>38</b>. At the same time, the pressure differential across the outbound check valve <b>42</b> causes the outbound check valve <b>42</b> to open. Thus, CO<sub>2 </sub>scrubbed gas is returned to oscillating line <b>14</b> through the normally open shut-off valve <b>44</b>. The gas returning to the oscillating line <b>14</b> via the discharge line <b>16</b> mixes with the gas in the oscillating line <b>14</b>. The gas in oscillating line <b>14</b> is moved toward the cutlet valve <b>52</b> when the inbound check valve <b>20</b> is closed by the movement of the oscillator <b>11</b>. <figref idref="DRAWINGS">FIGS. 2</figref><i>a </i>and <b>2</b><i>b </i>illustrate the open and closed positions of the pneumatic version of the outlet valve <b>52</b>. When the control pressure supplied by control line <b>54</b> exceeds the pressure in the oscillating line <b>14</b> (<figref idref="DRAWINGS">FIG. 2</figref><i>a </i>), the outlet valve <b>52</b> is in the closed position and gas from oscillating line <b>14</b> is prevented from escaping from the device <b>10</b>. When the control pressure supplied by control line <b>54</b> is less than the pressure in the oscillating line <b>14</b> (<figref idref="DRAWINGS">FIG. 2</figref><i>b</i>), the outlet valve <b>52</b> is in the open position and gas from oscillating line <b>14</b> is allowed to escape from the device <b>10</b>. In the embodiments shown in <figref idref="DRAWINGS">FIGS. 1 through 5</figref>, preferably the outlet valve <b>52</b> is closed for at least part of the expiration phase (i.e. when the pressure in oscillating line <b>14</b> is decreasing due to movement of the oscillator <b>11</b> away from the device <b>10</b>), and the outlet valve <b>52</b> is open for at least part of the inspiration phase (i.e. when the pressure in oscillating line <b>14</b> is increasing due to movement of the oscillator <b>11</b> toward the device <b>10</b>).
The CO<sub>2 </sub>scrubber canister <b>38</b> in the device <b>10</b> of the present invention may be used in other locations. For example, as shown in <figref idref="DRAWINGS">FIGS. 3</figref><i>a</i>, <b>3</b><i>b </i>and <b>3</b><i>c</i>, the scrubber canister <b>38</b> may be placed at the end of patient line <b>25</b> distal from the inbound line <b>15</b>. As shown in <figref idref="DRAWINGS">FIGS. 3</figref><i>a </i>and <b>3</b><i>c</i>, suitable check valves <b>20</b>, <b>42</b> and return line <b>67</b> can be incorporated to assure unidirectional flow through the scrubber canister <b>38</b>. A bypass line <b>66</b> could be provided to accommodate replacement of the scrubber canister <b>38</b>. In a preferred embodiment of the present invention, the second scrubber canister <b>68</b> is provided in the bypass line <b>66</b>. The second scrubber canister <b>68</b> may be incorporated into any embodiment described herein which has a scrubber canister <b>38</b>. The device depicted in <figref idref="DRAWINGS">FIGS. 3</figref><i>a</i>, <b>3</b><i>b </i>and <b>3</b><i>c </i>could be used with prior art ventilator circuits.
The scrubber canister <b>38</b> contains a material that removes unwanted gas, such as CO<sub>2</sub>. For example, the scrubber canister <b>38</b> may contain sodium hydroxide, calcium hydroxide, or barium hydroxide. Sodium hydroxide and calcium hydroxide mixed with silica is available as Soda Lime™. Another commercially available CO<sub>2 </sub>scrubber is Baralyme™ which comprises barium hydroxide and calcium hydroxide. Once the CO<sub>2 </sub>scrubber canister <b>38</b> is depleted of its scrubbing capacity, it can be replaced. To replace the scrubber canister <b>38</b>, the two-position valve <b>32</b> is set to direct the gas from the exhalation line <b>30</b> to the recirculation line <b>34</b>, while the shut-off valve <b>44</b> is set to the closed position. Upon replacement of the scrubber canister <b>38</b>, the two-position valve <b>32</b> and the shut-off valve <b>44</b> are reset to their normal positions.
<figref idref="DRAWINGS">FIGS. 4</figref><i>a </i>and <b>4</b><i>b </i>show two additional embodiments of the present invention. As illustrated in <figref idref="DRAWINGS">FIG. 4</figref><i>a</i>, the scrubber canister <b>38</b> may be placed in the oscillating line <b>14</b> upstream of the CO<sub>2 </sub>and O<sub>2 </sub>sensors <b>22</b>, <b>24</b>, or as shown in <figref idref="DRAWINGS">FIG. 4</figref><i>b</i>, downstream of the sensors <b>22</b>, <b>24</b>. In the embodiments shown in <figref idref="DRAWINGS">FIGS. 4</figref><i>a </i>and <b>4</b><i>b</i>, check valves are not required to direct the flow of inspiratory gas toward the patient line <b>25</b> or to direct the flow of expired gas toward the scrubber canister <b>38</b>. Normally, gas moves in both directions through the scrubber canister <b>38</b>. To replace the scrubber canister <b>38</b>, two block valves <b>62</b>, <b>64</b> can be temporarily adjusted so that gas flows through the bypass line <b>66</b>.
<figref idref="DRAWINGS">FIG. 5</figref> shows another embodiment of the present invention in which the scrubber is located in the oscillating line <b>14</b>, and gas flows through the scrubber canister <b>38</b> toward the patient line <b>25</b>. Flow from the patient line <b>25</b> moves through the exhalation line <b>30</b> to oscillating line <b>14</b>. A check valve <b>42</b> is in bypass line <b>66</b> to assure that flow moves through exhalation line <b>30</b> in one direction only. An additional check valve <b>20</b> may be included in oscillating line <b>14</b> to assure flow through the scrubber canister <b>38</b> in one direction only.
In another embodiment of the present invention, illustrated in <figref idref="DRAWINGS">FIG. 6</figref>, instead of scrubbing CO<sub>2 </sub>from the exhaled gas, the exhaled gas is simply allowed to leave a device <b>100</b>. The device <b>100</b> is connected to an inspiratory gas source <b>5</b> through connecting line <b>18</b>. The inspiratory gas enters an oscillating line <b>14</b> and moves toward the patient line <b>25</b> in the direction of arrow <b>21</b> via the inbound check valve <b>20</b>. CO<sub>2 </sub>and O<sub>2 </sub>sensors <b>22</b>, <b>24</b> and pressure monitoring port <b>28</b> can be placed near the patient line <b>25</b>. The exhaled gas is conducted by the exhalation line <b>30</b> to another type of outlet valve <b>52</b>. The outlet valve <b>52</b> shown in <figref idref="DRAWINGS">FIGS. 6</figref>, <b>7</b><i>a </i>and <b>7</b><i>b </i>operates based on the pressure differential between oscillating line <b>14</b> and the exhalation line <b>30</b>. During the pressurizing cycle, outlet valve <b>52</b> is caused to close the end <b>132</b> of exhalation line <b>30</b> by the rising pressure in oscillating line <b>14</b>. However, during the depressurizirig phase, the pressure in the outlet line <b>50</b> causes the outlet valve <b>52</b> to open the end <b>132</b> and allow gas to escape to the atmosphere. Preferably, for at least part of the pressurization cycle, outlet valve <b>52</b> is closed and there is no communication between the exhalation line <b>30</b> and the atmosphere, and for at least part of the depressurization cycle, outlet valve <b>52</b> is open and there is communication between line <b>30</b> and the atmosphere.
<figref idref="DRAWINGS">FIGS. 7</figref><i>a </i>and <b>7</b><i>b </i>show a preferred embodiment of the outlet valve <b>52</b> shown in <figref idref="DRAWINGS">FIG. 6</figref>. The outlet valve <b>52</b> in <figref idref="DRAWINGS">FIGS. 7</figref><i>a </i>and <b>7</b><i>b </i>has a first flexible membrane <b>300</b> disposed in the oscillating line <b>14</b> and a second flexible membrane <b>303</b> situated to selectively close the end <b>132</b> of the outlet line <b>50</b>. The flexible membranes <b>300</b>, <b>303</b> are connected by a pressure communication line <b>306</b>. The pressure communication line <b>306</b> may be filled with a gas or a fluid. When the pressure in the pressure communication line <b>306</b> is above the pressure in outlet line <b>50</b>, the end <b>132</b> of the outlet line <b>50</b> is closed by the second flexible membrane <b>303</b>. When the pressure in the outlet line <b>50</b> is above the pressure in the pressure communication line <b>306</b>, gas is allowed to escape from the end <b>132</b> of the outlet line <b>50</b>. It will be recognized that due to the first flexible membrane <b>300</b>, the pressure in oscillating line <b>14</b> will change the pressure in the pressure communication line <b>306</b>.
In a preferred embodiment, a control pressure line <b>309</b> is connected to the pressure communication line <b>306</b>. When the control pressure line <b>309</b> is provided, the pressure in the pressure communication line <b>306</b> may be changed, and thereby, the pressure in the outlet line <b>50</b> required to open the end <b>132</b> of the outlet line <b>50</b> may be changed.
In another embodiment of the invention shown in <figref idref="DRAWINGS">FIGS. 9</figref><i>a</i>, <b>9</b><i>b </i>and <b>9</b><i>c</i>, device <b>10</b> may be connected to an U-type oscillator tube (termed herein as a connecting tube) of the prior art. The U-type tubes typically have a gas supply line and an outlet valve or means. In this embodiment, the device has a gas flow circuit comprising an oscillating line, a patient line and a return line. The first end of the oscillating line <b>14</b> is adapted for communication with a connector <b>402</b> of the U-type oscillator tube <b>400</b> as indicated by dotted lines <b>404</b>. The second end of the oscillating line <b>14</b> is connected to patient line <b>25</b>. A return line <b>67</b> is provided for return of exhaled air. The return line at both ends is connected to the oscillating line. On the oscillating line between the ends of the return line is located check valve <b>20</b> to move the gas toward patient line <b>25</b>. A CO<sub>2 </sub>scrubber <b>38</b> is located in the return line (<figref idref="DRAWINGS">FIG. 9</figref><i>a</i>) or in the oscillating line (<figref idref="DRAWINGS">FIG. 9</figref><i>b</i>). In a preferred embodiment (<figref idref="DRAWINGS">FIG. 9</figref><i>a</i>), another check valve <b>42</b> is provided in the return line. The device may also have a gas supply line and an outlet valve. For use of this device directly with an oscillating ventilator <b>410</b> as indicated by dotted lines <b>404</b> (<figref idref="DRAWINGS">FIG. 9</figref><i>d</i>), a gas supply line <b>8</b> having a flow regulator <b>9</b> is connected to any location in the gas flow circuit through connecting line <b>18</b>. An outlet valve <b>52</b> may also be placed at any location in the gas flow circuit. One example of a location for the supply line <b>18</b> and outlet valve <b>52</b> is shown in <figref idref="DRAWINGS">FIG. 9</figref><i>d</i>. The scrubber canister <b>38</b> may be placed at any location in the oscillating line or return line, but is preferably placed in the return line. Optionally, as shown in <figref idref="DRAWINGS">FIG. 9</figref><i>c</i>, a second CO<sub>2 </sub>scrubber canister <b>68</b> may be provided in another return line <b>66</b>. Scrubber valves <b>70</b>A and <b>70</b>B operate as described above such that either scrubber canister <b>38</b> or scrubber canister <b>68</b> is in use. Oxygen and CO<sub>2 </sub>sensors, and pressure monitoring devices can also be placed in the gas flow circuit as shown in <figref idref="DRAWINGS">FIGS. 1</figref>, <b>4</b><i>a</i>, <b>4</b><i>b </i>or <b>6</b>.
To illustrate the concept of the present invention, mathematical relationships were developed for the device <b>10</b> shown in <figref idref="DRAWINGS">FIG. 1</figref>. Tables 1–10 below list data corresponding to these mathematical relationships. In the tables:
VO<sub>2 </sub>is the volume rate of oxygen consumed by the patient;
VI is the volume rate of inspiratory gas supplied to the device <b>10</b>;
FiO<sub>2 </sub>is the mole fraction of oxygen in the inspiratory gas;
FmO<sub>2 </sub>is the mole fraction of oxygen in the mixed gas crossing inbound check valve <b>20</b>;
FiO<sub>2</sub>=1-FiN<sub>2</sub>. where FiN<sub>2 </sub>is the mole fraction of nitrogen in the inspiratory gas;
FmO<sub>2</sub>=1-FmN<sub>2</sub>, where FmN<sub>2 </sub>is the mole fraction of nitrogen in the mixed gas exiting the outlet valve <b>52</b>;
VI=K+VO<sub>2</sub>, where K=outflow volume from outlet valve;
VI×FiN<sub>2</sub>=K×FmN<sub>2</sub>;
VI(1-FiO<sub>2</sub>)=<i>K</i>(1-FmO<sub>2</sub>);
(VI÷K)(1-FiO<sub>2</sub>=1-FmO<sub>2</sub>;
FmO<sub>2</sub>=1−((VI÷K)(1-FiO<sub>2</sub>)).
<tables id="TABLE-US-00001" num="00001"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 1</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.21</entry><entry>−3.74</entry><entry>−17.81</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.21</entry><entry>−0.58</entry><entry>−2.76</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.21</entry><entry>−0.05</entry><entry>−0.25</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.21</entry><entry>0.05</entry><entry>0.25</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.21</entry><entry>0.10</entry><entry>0.46</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.21</entry><entry>0.12</entry><entry>0.58</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.21</entry><entry>0.14</entry><entry>0.66</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.21</entry><entry>0.15</entry><entry>0.71</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.21</entry><entry>0.16</entry><entry>0.75</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.21</entry><entry>0.16</entry><entry>0.78</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.21</entry><entry>0.17</entry><entry>0.80</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.21</entry><entry>0.19</entry><entry>0.90</entry><entry>195.0</entry><entry>40.0*</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.21</entry><entry>0.20</entry><entry>0.96</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.21</entry><entry>0.21</entry><entry>0.98</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00002" num="00002"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 2</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.30</entry><entry>−3.20</entry><entry>−10.67</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.30</entry><entry>−0.40</entry><entry>−1.33</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.30</entry><entry>0.07</entry><entry>0.22</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.30</entry><entry>0.16</entry><entry>0.53</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.30</entry><entry>0.20</entry><entry>0.67</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.30</entry><entry>0.22</entry><entry>0.74</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.30</entry><entry>0.24</entry><entry>0.79</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.30</entry><entry>0.25</entry><entry>0.82</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.30</entry><entry>0.25</entry><entry>0.84</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.30</entry><entry>0.26</entry><entry>0.86</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.30</entry><entry>0.26</entry><entry>0.88</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.30</entry><entry>0.28</entry><entry>0.94</entry><entry>195.0</entry><entry>40.0*</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.30</entry><entry>0.29</entry><entry>0.98</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.30</entry><entry>0.30</entry><entry>0.99</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00003" num="00003"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 3</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.40</entry><entry>−2.60</entry><entry>−6.50</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.40</entry><entry>−0.20</entry><entry>−0.50</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.40</entry><entry>0.20</entry><entry>0.50</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.40</entry><entry>0.28</entry><entry>0.70</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.40</entry><entry>0.31</entry><entry>0.79</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.40</entry><entry>0.33</entry><entry>0.83</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.40</entry><entry>0.35</entry><entry>0.86</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.40</entry><entry>0.35</entry><entry>0.88</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.40</entry><entry>0.36</entry><entry>0.90</entry><entry>75.0</entry><entry>16.0*</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.40</entry><entry>0.36</entry><entry>0.91</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.40</entry><entry>0.37</entry><entry>0.92</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.40</entry><entry>0.38</entry><entry>0.96</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.40</entry><entry>0.39</entry><entry>0.98</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.40</entry><entry>0.40</entry><entry>0.99</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00004" num="00004"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 4</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.50</entry><entry>−2.00</entry><entry>−4.00</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.50</entry><entry>0.00</entry><entry>0.00</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.50</entry><entry>0.33</entry><entry>0.67</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.50</entry><entry>0.40</entry><entry>0.80</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.50</entry><entry>0.43</entry><entry>0.86</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.50</entry><entry>0.44</entry><entry>0.89</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.50</entry><entry>0.45</entry><entry>0.91</entry><entry>55.0</entry><entry>12.0*</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.50</entry><entry>0.46</entry><entry>0.92</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.50</entry><entry>0.47</entry><entry>0.93</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.50</entry><entry>0.47</entry><entry>0.94</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.50</entry><entry>0.47</entry><entry>0.95</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.50</entry><entry>0.49</entry><entry>0.97</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.50</entry><entry>0.49</entry><entry>0.99</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.50</entry><entry>0.50</entry><entry>0.99</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00005" num="00005"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 5</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.60</entry><entry>−1.40</entry><entry>−2.33</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.60</entry><entry>0.20</entry><entry>0.33</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.60</entry><entry>0.47</entry><entry>0.78</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.60</entry><entry>0.52</entry><entry>0.87</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.60</entry><entry>0.54</entry><entry>0.90</entry><entry>35.0</entry><entry>8.0*</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.60</entry><entry>0.56</entry><entry>0.93</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.60</entry><entry>0.56</entry><entry>0.94</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.60</entry><entry>0.57</entry><entry>0.95</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.60</entry><entry>0.57</entry><entry>0.96</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.60</entry><entry>0.58</entry><entry>0.96</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.60</entry><entry>0.58</entry><entry>0.96</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.60</entry><entry>0.59</entry><entry>0.98</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.60</entry><entry>0.60</entry><entry>0.99</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.60</entry><entry>0.60</entry><entry>1.00</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00006" num="00006"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 6</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.70</entry><entry>−0.80</entry><entry>−1.14</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.70</entry><entry>0.40</entry><entry>0.57</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.70</entry><entry>0.60</entry><entry>0.86</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.70</entry><entry>0.64</entry><entry>0.91</entry><entry>25.0</entry><entry>6.0*</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.70</entry><entry>0.67</entry><entry>0.94</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.70</entry><entry>0.67</entry><entry>0.95</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.70</entry><entry>0.68</entry><entry>0.96</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.70</entry><entry>0.68</entry><entry>0.97</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.70</entry><entry>0.68</entry><entry>0.97</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.70</entry><entry>0.68</entry><entry>0.97</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.70</entry><entry>0.68</entry><entry>0.98</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.70</entry><entry>0.69</entry><entry>0.99</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.70</entry><entry>0.70</entry><entry>1.00</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.70</entry><entry>0.70</entry><entry>1.00</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00007" num="00007"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 7</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.80</entry><entry>−0.20</entry><entry>−0.25</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.80</entry><entry>0.60</entry><entry>0.75</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.80</entry><entry>0.73</entry><entry>0.92</entry><entry>15.0</entry><entry>4.0*</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.80</entry><entry>0.76</entry><entry>0.95</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.80</entry><entry>0.77</entry><entry>0.96</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.80</entry><entry>0.78</entry><entry>0.97</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.80</entry><entry>0.78</entry><entry>0.98</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.80</entry><entry>0.78</entry><entry>0.98</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.80</entry><entry>0.79</entry><entry>0.98</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.80</entry><entry>0.79</entry><entry>0.99</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.80</entry><entry>0.79</entry><entry>0.99</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.80</entry><entry>0.79</entry><entry>0.99</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.80</entry><entry>0.80</entry><entry>1.00</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.80</entry><entry>0.80</entry><entry>1.00</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00008" num="00008"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 8</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>0.90</entry><entry>0.40</entry><entry>0.44</entry><entry>1.0</entry><entry>1.2</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>0.90</entry><entry>0.80</entry><entry>0.89</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.90</entry><entry>0.87</entry><entry>0.96</entry><entry>15.0</entry><entry>4.0*</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.90</entry><entry>0.88</entry><entry>0.98</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.98</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>0.90</entry><entry>0.89</entry><entry>0.99</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.90</entry><entry>0.90</entry><entry>1.00</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>0.90</entry><entry>0.90</entry><entry>1.00</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.90</entry><entry>0.90</entry><entry>1.00</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00009" num="00009"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="28pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="35pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="35pt" align="center" /><thead><row><entry namest="1" nameend="7" rowsep="1">TABLE 9</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>Vi ÷ VO<sub>2</sub></entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="7"><colspec colname="1" colwidth="35pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="28pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="35pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="35pt" align="char" char="." /><tbody valign="top"><row><entry>5.0</entry><entry>6.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>1.0</entry><entry>1.2*</entry></row><row><entry>5.0</entry><entry>10.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>5.0</entry><entry>2.0</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>15.0</entry><entry>4.0</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>25.0</entry><entry>6.0</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>35.0</entry><entry>8.0</entry></row><row><entry>5.0</entry><entry>50.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>45.0</entry><entry>10.0</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>55.0</entry><entry>12.0</entry></row><row><entry>5.0</entry><entry>70.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>65.0</entry><entry>14.0</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>75.0</entry><entry>16.0</entry></row><row><entry>5.0</entry><entry>90.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>85.0</entry><entry>18.0</entry></row><row><entry>5.0</entry><entry>100.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>95.0</entry><entry>20.0</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>195.0</entry><entry>40.0</entry></row><row><entry>5.0</entry><entry>500.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>495.0</entry><entry>100.0</entry></row><row><entry>5.0</entry><entry>1000.0</entry><entry>0.00</entry><entry>1.00</entry><entry>1.00</entry><entry>995.0</entry><entry>200.0</entry></row><row><entry namest="1" nameend="7" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
<tables id="TABLE-US-00010" num="00010"><table frame="none" colsep="0" rowsep="0"><tgroup align="left" colsep="0" rowsep="0" cols="8"><colspec colname="1" colwidth="28pt" align="center" /><colspec colname="2" colwidth="28pt" align="center" /><colspec colname="3" colwidth="21pt" align="center" /><colspec colname="4" colwidth="28pt" align="center" /><colspec colname="5" colwidth="28pt" align="center" /><colspec colname="6" colwidth="28pt" align="center" /><colspec colname="7" colwidth="28pt" align="center" /><colspec colname="8" colwidth="28pt" align="center" /><thead><row><entry namest="1" nameend="8" rowsep="1">TABLE 10</entry></row><row><entry namest="1" nameend="8" align="center" rowsep="1" /></row><row><entry>VO<sub>2</sub></entry><entry>VI</entry><entry /><entry /><entry /><entry>K</entry><entry /><entry /></row><row><entry>ml/kg/</entry><entry>ml/kg/</entry><entry /><entry /><entry>FmO<sub>2 </sub>÷</entry><entry>ml/kg/</entry><entry>VI ÷</entry><entry>Toler-</entry></row><row><entry>min</entry><entry>min</entry><entry>FiO<sub>2</sub></entry><entry>FmO<sub>2</sub></entry><entry>FiO<sub>2</sub></entry><entry>min</entry><entry>VO<sub>2</sub></entry><entry>ance</entry></row><row><entry namest="1" nameend="8" align="center" rowsep="1" /></row></thead><tbody valign="top"><row><entry /></row></tbody></tgroup><tgroup align="left" colsep="0" rowsep="0" cols="8"><colspec colname="1" colwidth="28pt" align="char" char="." /><colspec colname="2" colwidth="28pt" align="char" char="." /><colspec colname="3" colwidth="21pt" align="char" char="." /><colspec colname="4" colwidth="28pt" align="char" char="." /><colspec colname="5" colwidth="28pt" align="char" char="." /><colspec colname="6" colwidth="28pt" align="char" char="." /><colspec colname="7" colwidth="28pt" align="char" char="." /><colspec colname="8" colwidth="28pt" align="center" /><tbody valign="top"><row><entry>5.0</entry><entry>200.0</entry><entry>0.21</entry><entry>0.19</entry><entry>0.90</entry><entry>195.0</entry><entry>40.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>200.0</entry><entry>0.30</entry><entry>0.28</entry><entry>0.94</entry><entry>195.0</entry><entry>40.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>80.0</entry><entry>0.40</entry><entry>0.36</entry><entry>0.90</entry><entry>75.0</entry><entry>16.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>60.0</entry><entry>0.50</entry><entry>0.45</entry><entry>0.91</entry><entry>55.0</entry><entry>12.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>40.0</entry><entry>0.60</entry><entry>0.54</entry><entry>0.90</entry><entry>35.0</entry><entry>8.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>30.0</entry><entry>0.70</entry><entry>0.64</entry><entry>0.91</entry><entry>25.0</entry><entry>6.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.80</entry><entry>0.73</entry><entry>0.92</entry><entry>15.0</entry><entry>4.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>20.0</entry><entry>0.90</entry><entry>0.87</entry><entry>0.96</entry><entry>15.0</entry><entry>4.0</entry><entry>10%</entry></row><row><entry>5.0</entry><entry>6.0</entry><entry>1.00</entry><entry>1.00</entry><entry>1.00</entry><entry>1.0</entry><entry>0.83</entry><entry>10%</entry></row><row><entry namest="1" nameend="8" align="center" rowsep="1" /></row></tbody></tgroup></table></tables>
Tables 1–9 illustrate the FmO<sub>2 </sub>achieved at various inspiratory gas flow rates (VI) assuming an oxygen consumption rate of 5 ml/kg/min. An asterisk in the column labeled VI/VO<sub>2 </sub>indicates the minimum flow rate of inspiratory gas needed to achieve an FmO2 that is within 10% of the corresponding FiO<sub>2</sub>. The inspiratory gas corresponding to Table 1 was air (21% oxygen). As seen in Table 1, an inspiratory gas flow rate of 50 ml/kg/min results in the fraction of O<sub>2 </sub>in the mixed gas (mixture of inspiratory gas and scrubbed exhaled gas) to be about 0.12. Thus, the ratio of FmO<sub>2 </sub>to FiO<sub>2 </sub>is about 0.58. To achieve the fraction of oxygen in the mixed gas (FmO<sub>2</sub>) to be within 10% of the FiO<sub>2</sub>, a flow rate of inspiratory gas of 200 ml/min is needed.
Tables 2–9 illustrate the flow rate of inspiratory gas required for FiO<sub>2 </sub>values of 0.3 (30% oxygen) to 1.0 (pure oxygen). With a higher percentage of oxygen in the inspiratory gas, a lower flow of inspiratory gas is needed to achieve the same ratio of FmO<sub>2 </sub>to FiO<sub>2 </sub>For example to achieve an FmO<sub>2 </sub>value that is within 10% of FiO2, for gas containing 21% oxygen (air) an inspiratory gas flow rate of 200 ml/min is required, whereas for inspiratory gas containing 80% oxygen, a 10 times lower inspiratory gas flow rate (20 ml/kg/min) is required (Table 7). Table 10 presents a composite of inspiratory gas flow rates for various concentrations of oxygen in the inspiratory gas to achieve an FmO<sub>2 </sub>value that is within 10% of the FiO<sub>2 </sub>(10% tolerance level). As seen in Table 10, to deliver a desired concentration of oxygen to the patient line <b>25</b>, one could adjust the inspiratory gas flow keeping the FiO<sub>2 </sub>constant, or one could adjust the FiO<sub>2 </sub>keeping the inspiratory gas flow rate constant.
The data presented in these tables illustrates that by using the device of the present invention, inspiratory gas flow rates can be reduced to 6 to 200 ml/kg/min. This compares to an inspiratory gas flow rate of approximately 1000 to 2000 ml/kg/min required with currently available high frequency oscillatory ventilators.
<figref idref="DRAWINGS">FIG. 8</figref> shows steps of a method according to the present invention. In the method, a ventilating device, such as the device <b>10</b> described above, is provided (step <b>200</b>). In addition, a patient connected to the patient line is provided (step <b>203</b>) and gas is supplied with the gas supply line to the oscillating line (step <b>206</b>). The oscillator is moved toward the oscillating line and the outlet valve is opened (step <b>209</b>). Then, the oscillator is moved away from the oscillating line and the outlet valve is closed (step <b>212</b>). Preferably, the gas is supplied to the oscillating line at approximately a constant flow rate.
Devices and methods according to the present invention are more efficient than currently available high frequency oscillating ventilators primarily because the present invention substantially reduces the need for bias flow. This reduction in bias flow enables smaller ventilation systems. It is now clear the device and method of the present invention reduces the volume of bias flow required for safe ventilation. By using the present device, it is believed the volume of inspiratory gas delivered to the ventilator can be reduced from 20,000 to 80,000 ml/min to as little as 20 to 800 ml/min.
Another advantage of the present invention may be to counter the loss of mean lung volume associated with prolonged oscillatory ventilation, which is believed to be a problem with this form of mechanical ventilation. It is currently believed by some that this problem might be intensified by reductions in inspiratory gas flow. One approach to this problem that may counter a tendency to lose mean lung volume and thus preserve lung expansion involves redirection of some or all of the inspiratory gas flow to a small channel adapted to the endotracheal tube to allow delivery of some or all of the bias flow directly to the trachea. While potentially hazardous at high (conventional) inspiratory gas flow rates, it is believed that this would be safe at the lower inspiratory gas flow rates envisioned for this invention. Moreover, it is recognized that there might be some advantage to redirecting some or all of the inspiratory gas flow to the distal trachea (closer to the lungs) even when practicing oscillation using conventional high flow rates of inspiratory gas. Redirection of some or all of the inspiratory gas to the trachea would trap inspiratory gas in the lung during the inspiratory phase of the cycle, and release it to the device <b>10</b> at lower pressure during the expiratory phase. This should aid in the expansion of an atelectatic or de-recruited lung.
Although embodiments of the invention have been described herein, the invention is not limited to such embodiments. The claims which follow are directed to the invention, and are intended to further describe the invention, but are not intended to limit the scope of the invention.
Contents5
12 sheets
Sheet 1 Sheet 2 Sheet 3 Sheet 4 Sheet 5 Sheet 6 Sheet 7 Sheet 8 Sheet 9 Sheet 10 Sheet 11 Sheet 12
Every citation, both waysCites: the store holds 36 of 37
| Document | Relation | Office | Cited during |
|---|---|---|---|
| US2014034050A1 | Cited by | United States of America | Pre-grant |
| US2005247316A1 | Cited by | United States of America | Pre-grant |
| US7621272B2 | Cited by | United States of America | Search report |
| US9032954B2 | Cited by | United States of America | Search report |
| US12465704B2 | Cited by | United States of America | Applicant |
| US2008041385A1 | Cited by | United States of America | Pre-grant |
| US11992611B2 | Cited by | United States of America | Applicant |
| US10905837B2 | Cited by | United States of America | Applicant |
| US7891356B2 | Cited by | United States of America | Applicant |
| US8671942B2 | Cited by | United States of America | Applicant |
| US2008276940A1 | Cited by | United States of America | Pre-grant |
| US10314991B2 | Cited by | United States of America | Search report |
| US2010212668A1 | Cited by | United States of America | Pre-grant |
| US10905836B2 | Cited by | United States of America | Applicant |
| EP0621049A1 | Cites | European Patent Office (EPO) | Applicant |
| US1693730A | Cites | United States of America | Applicant |
| GB2062475A | Cites | United Kingdom | Applicant |
| US3396723A | Cites | United States of America | Applicant |
| US4127121A | Cites | United States of America | Applicant |
| US4354536A | Cites | United States of America | Applicant |
| US4466433A | Cites | United States of America | Applicant |
| US4543951A | Cites | United States of America | Applicant |
| US4637385A | Cites | United States of America | Applicant |
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| US4951659A | Cites | United States of America | Applicant |
| US4989597A | Cites | United States of America | Applicant |
| US5092326A | Cites | United States of America | Applicant |
| US5107830A | Cites | United States of America | Applicant |
| US5165398A | Cites | United States of America | Applicant |
| US5299579A | Cites | United States of America | Applicant |
| US5307794A | Cites | United States of America | Search report |
| US5471979A | Cites | United States of America | Applicant |
| US5520172A | Cites | United States of America | Applicant |
| US5555880A | Cites | United States of America | Applicant |
| US5694924A | Cites | United States of America | Applicant |
| US5730119A | Cites | United States of America | Applicant |
| US5850835A | Cites | United States of America | Applicant |
| US6591836B1 | Cites | United States of America | Search report |
| WO8807876A1 | Cites | World Intellectual Property Organization (WIPO) | Applicant |
| EP621049A1 | Cites | European Patent Office (EPO) | Third party observation |
| GB2062475 | Cites | United Kingdom | Third party observation |
| WO8807876 | Cites | World Intellectual Property Organization (WIPO) | Third party observation |
| Lunkenbeimer et al., Intrapulmonaler Gaswechsel unter simulierter Apnoe durch transtrachealen, periodischen intrathorakalen Druckwechsel, Anaethesist, 1972, vol. 22, pp. 232-238. English translation attached (Intrapulmonary Gas Exchange Under Simulated Apnea by Transtracheal Periodic Intrathoracic Pressure Changes). | Non-patent | – | Applicant |
| Ngeow et al., A New System for Ventilating with High-Frequency Oscillation, American Physiological Society, 1982, pp. 1638-1642. | Non-patent | – | Applicant |
| Lunkenbeimer et al., <i>Intrapulmonaler Gaswechsel unter simulierter Apnoe durch transtrachealen, periodischen intrathorakalen Druckwechsel</i>, Anaethesist, 1972, vol. 22, pp. 232-238. English translation attached (<i>Intrapulmonary Gas Exchange Under Simulated Apnea by Transtracheal Periodic Intrathoracic Pressure Changes</i>). | Non-patent | – | Third party observation |
| Ngeow et al., <i>A New System for Ventilating with High-Frequency Oscillation</i>, American Physiological Society, 1982, pp. 1638-1642. | Non-patent | – | Third party observation |
26 members in 11 offices
Priority claims14
| Document | Office | Kind | Date |
|---|---|---|---|
| 14686399 | United States of America | P | |
| 14686399 | United States of America | P | |
| 63146400 | United States of America | A | |
| 63146400 | United States of America | A | |
| 35346102 | United States of America | P | |
| 35346102 | United States of America | P | |
| 35690203 | United States of America | A | |
| 09631464 | – | – | – |
| 60146863 | – | – | – |
| 60353461 | – | – | – |
| US19990146863P | – | – | – |
| US20000631464 | – | – | – |
| US20020353461P | – | – | – |
| US20030356902 | – | – | – |
Members26
| Document | Office | Kind | |
|---|---|---|---|
| CA2387632A1 | Canada | A1 | |
| WO0108736A1 | World Intellectual Property Organization (WIPO) | A1 | |
| AU6618500A | Australia | A | |
| EP1225944A1 | European Patent Office (EPO) | A1 | |
| HK1044903A | Hong Kong, China | A | |
| HK1044903A1 | Hong Kong, China | A1 | |
| JP2003505214A | Japan | A | |
| US6591836B1 | United States of America | B1 | |
| CA2474428A1 | Canada | A1 | |
| US2003145855A1 | United States of America | A1 | |
| WO03063751A2 | World Intellectual Property Organization (WIPO) | A2 | |
| WO03063751A3 | World Intellectual Property Organization (WIPO) | A3 | |
| EP1225944A4 | European Patent Office (EPO) | A4 | |
| WO2004074746A2 | World Intellectual Property Organization (WIPO) | A2 | |
| EP1476225A2 | European Patent Office (EPO) | A2 | |
| BR0307412A | Brazil | A | |
| WO2004074746A3 | World Intellectual Property Organization (WIPO) | A3 | |
| JP2005515840A | Japan | A | |
| MXPA04007412A | Mexico | A | |
| US7007693B2This record | United States of America | B2 | |
| EP1225944B1 | European Patent Office (EPO) | B1 | |
| AT339984T | Austria | T | |
| ATE339984T1 | Austria | T1 | |
| DE60030873D1 | Germany | D1 | |
| DE60030873T2 | Germany | T2 | |
| EP1476225A4 | European Patent Office (EPO) | A4 |
54 transactions on the USPTO file
Allowed after 1 non-final rejection and 1 final rejection.
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- 1
- RCEs
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| Event | Code | |
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| Dispatch to FDCD1935 | D1935 | |
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| Issue Fee Payment VerifiedN084 | N084 | |
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| Response after Non-Final ActionA... | A... | |
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8 legal events, as the office reported them to INPADOC
Over the term
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|---|---|---|
| Lapsed due to failure to pay maintenance feeLapsedFP | FP | |
| Information on status: patent discontinuationPATENT EXPIRED DUE TO NONPAYMENT OF MAINTENANCE FEES UNDER 37 CFR 1.362STCH | STCH | |
| Information on status: patent discontinuationPATENT EXPIRED DUE TO NONPAYMENT OF MAINTENANCE FEES UNDER 37 CFR 1.362STCH | STCH | |
| Lapse for failure to pay maintenance feesLapsedLAPS | LAPS | |
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| Fee paymentFPAY | FPAY | |
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| AssignmentAS | AS |
Numbers
- Publication
- 07007693
- Publication, DOCDB
- 7007693
- Publication, EPODOC
- US7007693
- Application
- 10356902
- Application, DOCDB
- 35690203
- Application, EPODOC
- US20030356902
Titles
- English
- Device and method of reducing bias flow in oscillatory ventilators
Patent term adjustment
- A delay
- +310 daysthe office missed an examination deadline
- Applicant delay
- −4 days
- Net adjustment
- 306 days
Classification
- CPC, 14
- A61M16/20
- A61M16/0096
- A61M16/06
- A61M16/10
- A61M16/22
- A61M2016/0027
- A61M2016/1025
- A61M2016/103
- A61M2230/432
- A61M2230/435
- A62B3/00
- A62C33/00
- A61M16/206
- A61M16/0858
- IPC, 8
- A61M16 00
- A62B19 00
- A61M16 06
- A61M16 10
- A61M16 20
- A61M16 22
- A62B3 00
- A62C33 00
- USPC, 5
- 128205120
- 128204220
- 128204230
- 128205240
- 128205280